A renowned Ohio State specialist is breaking ground in the treatment of lymphedema, painful swelling that can sometimes result from cancer treatment. &ldquo;We have a really comprehensive team and are on the cutting edge,&rdquo; says Roman Skoracki, MD, the division chief for Oncologic Plastic Surgery at the OSUCCC &ndash; James. Lymph nodes are the body&rsquo;s drainage and filtration system, and an interruption in this vast network can create fluid build-up and painful swelling in the arms and legs. In many breast cancer patients, cancer has spread to the lymph nodes in the armpit area. &ldquo;If we intervene and do preventative bypass microsurgery, we can reduce the incidence of lymphedema from about 40 percent down to four to eight percent,&rdquo; Skoracki explains, adding that not all hospitals offer this type of advanced, preventative microsurgery. Skoracki is also a leader in what is known as lymph node transfer surgery, a surgical technique in which lymph nodes from other parts of the body are transplanted into the armpits or forearms of breast cancer patients with lymphedema to reduce their symptoms. Skoracki is able to reattach the blood vessels of these &ldquo;donor&rdquo; lymph nodes &mdash; sometimes less than a millimeter in diameter &mdash; to blood vessels at the site to reestablish the blood flow necessary for successful transplants. Initially, lymph nodes were taken primarily from the groin area, but this led to lymphedema issues in the legs of some patients. &ldquo;We moved away from the groin to lower down in the armpit, and some from the lower neck or under the chin,&rdquo; Skoracki says, adding that there were still lymphedema issues in some patients. &ldquo;So, we explored other areas.&rdquo; Skoracki and his team began using lymph nodes from the abdomen area &ldquo;because we noticed a significant redundancy of lymph nodes in this area.&rdquo; Still not satisfied, Skoracki continued to look for alternative lymph node sites. &ldquo;The mesenteric lymph nodes seemed ideal,&rdquo; he says. &ldquo;They&rsquo;re in the area of the small bowel, and there are numerous redundancies, with 80 or 90 lymph nodes in the area, and we&rsquo;ve been using this site for about five years.&rdquo; On our James Cancer-Free World podcast, Skoracki explains the basics of microsurgery and super microsurgery, and how it can be applied to improve the outcomes for breast cancer patients.